Medico-legal encounters of 2015 Nepal earthquake - Path traversed and the road ahead.

The Gorkha Earthquake hit the region on 25th of April 2015, at 12:58, with the
epicentre approximately 80 km N-NW of Kathmandu, recording 7.8 M(w) on the
Richter Scale. The disaster left almost 9000 individuals dead. The search and
recovery as well as the subsequent Disaster Victim Identification (DVI)
operations left much to be desired. The entire DVI operations consisted of
examination of 365 bodies and collection of 15 blood/hair samples and 60
bone/tooth samples. This resulted in the scientific identification of eight
individuals and visual recognition of 357. The scientific basis of identification
of more than 8000 individuals, remains a question. The Disaster Response was
hampered by miscommunication, incoordination and mismanagement on the part of all
stakeholders and could have led to misidentification as well as missed
identification. This demonstrates the importance of systematic management of dead
bodies in mass casualty events to ensure dignity and respect of the deceased as
well as family members. The helplessness felt by technical experts was compounded
by the general lack of political will and the pressure on the law enforcement for
quick disposal, irrespective of the available standards and protocols. Therefore,
DVI operations can only be assumed to be a disaster in the making, when faced
with lack of political will, lack of strict adherence to international standards
as well as lack of determination from all stakeholders. Such a response from
authorities is usually driven by panic following mass fatalities especially in
disasters of great magnitude, like this one. The article discusses the challenges
faced by the technical experts in the field and describes the advancements as
well as recommendations for further improving the DVI operations in a
resource-stricken country.